Orthopedic augments having recessed pockets

ABSTRACT

Systems, devices, and methods for providing orthopedic augments having recessed pockets that receive a fixation material. The orthopedic augments include an outer surface that interfaces with a patient&#39;s tissue or bone, and an inner surface that interfaces with an implant, the inner surface defining a recessed pocket configured to receive a fixation material, a rim around at least a portion of the recessed pocket, and a port in the rim, wherein the recessed pocket extends along the inner surface in at least a direction laterally from the port.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional PatentApplication No. 61/568,023, filed Dec. 7, 2011, which is herebyincorporated by reference herein in. its entirety.

BACKGROUND

Joints often undergo degenerative changes due to a variety of reasons.When joint degeneration becomes advanced or irreversible, it may becomenecessary to replace the natural joint with a prosthetic joint.Artificial implants, including hip joints, shoulder joints, and kneejoints are widely used in orthopedic surgery. Specifically, hip jointprostheses are common. The human hip joint acts mechanically as a balland socket joint, wherein the ball-shaped head of the femur ispositioned within the socket-shaped acetabulum of the pelvis. Variousdegenerative diseases and injuries may require replacement of all or aportion of a hip using synthetic materials, typically metals, ceramics,or plastics.

It may become necessary to conduct a second or subsequent surgery inorder to replace a prosthetic joint with a (often larger) replacementjoint. Such surgeries, known as “revision” surgeries, often occur due tofurther degeneration of bone or advancement of a degenerative disease,requiring removal of further bone and replacement of the removed,diseased bone with a larger or enhanced prosthetic joint, often referredto as a revision prosthesis. For example, bone is often lost around therim of the acetabulum, and this may provide less rim coverage tosecurely place an acetabular cup.

In cases where the patient's bone around an implant is compromised, itmay be necessary to utilize an augment to add additional support. Forexample, an acetabular augment may be placed to fill in a defect cavityaround the acetabular shell to help support the loads transmitted to theshell. As part of the surgical technique, the surgeon may place both theshell and augment within the patient in order to ensure a proper fitbefore fastening the two components together to prevent motion betweenthem. However, fastening the two components may be difficult,particularly when using bone cement, if the two components arecongruent. Inadequate cementing between the components may cause them toseparate after implantation, possibly causing particle generation andleading ultimately to revision.

In current augment designs no provision is typically given to assistwith cement application. Therefore, surgeons apply the cement ad hoc(e.g., along the edges of the augment similar to a caulking bead) beforefully assembling the components together or forgo the use of cementaltogether. This leads to inconsistent and sometimes undesirable resultswith techniques that are not easily replicated.

SUMMARY

Disclosed herein are systems, devices, and methods for orthopedicaugments having retaining pockets. In certain embodiments, the systems,devices, and methods include an orthopedic augment comprising an outersurface that interfaces with a patient's tissue or bone, and an innersurface that interfaces with an implant, the inner surface comprising arecessed pocket configured to receive a fixation material, a rim aroundat least a portion of the recessed pocket, and a port in the rim. Therim can mate with an implant. In certain embodiments, the recessedpocket extends along the inner surface in at least a direction laterallyfrom the port. The port extends from the outer surface to the innersurface and thereby allows insertion of the fixation material into therecessed pocket.

In certain embodiments, the recessed pocket comprises a firstcompartment and a second compartment separated by a ridge. The ridge maybe recessed relative to the rim. The fixation material rigidly affixesthe augment to the implant. In certain embodiments, the fixationmaterial is a cement or paste. In certain embodiments, the orthopedicaugment further comprises a second port. The second port may be a fillgauge positioned inferiorly to the port, and the second port may have ageometry that is different than the geometry of the port. In certainembodiments, the port comprises a luer-lock fitting or a plug, and theport may be tapered. In certain embodiments, the orthopedic augment mayfurther comprise an extension member configured to couple with aninsertion device. The orthopedic augment may further comprise flanges,blades, hooks, or plates.

In certain embodiments, a surface of the augment is at least one ofpolished, matte, and porous. In certain embodiments, at least a portionof the outer surface comprises a polished finish. The outer surface mayfurther comprise a matte finish or porous composition. In certainembodiments, the upper surface comprises a porous composition.

In certain embodiments, methods for implanting an orthopedic augmentinclude placing an inner surface of the augment adjacent to an implant,wherein the inner surface comprises a recessed pocket and sport, andinserting a fixation material into the recessed pocket of the augmentvia the port, thereby affixing the augment to the implant. In certainembodiments, the inner surface of the augment further comprises aplurality of ports. The method may further include using at least one ofthe plurality of ports as a fill gauge, whereby the fixation material isinjected into a first port until the fixation material is observed via asecond port used as the fill gauge. The method may further includeselecting a first port within which to inject the fixation material intothe recessed pocket, and injecting the fixation material into therecessed pocket until the fixation element is observed passing a secondport. In certain embodiments, the method includes determining apreferred orientation of the augment with respect to the implant andselecting, in response to the determining, one of the plurality of portswithin which to inject the fixation material.

In certain embodiments, the recessed pocket comprises a firstcompartment and a second compartment. The port may be disposed proximatethe first compartment. The method may further include injecting thefixation material into the first compartment via the port, whereinoverfilling the first compartment causes the fixation material to flowinto the second compartment. The fixation material may be a cement orpaste and the implant may be an acetabular shell or cage.

In certain embodiments, a surface of the augment is at least one ofpolished, matte, and porous. In certain embodiments, at least a portionof the outer surface comprises a polished finish. The outer surface mayfurther comprise a matte finish or porous composition. In certainembodiments, the upper surface comprises a porous composition.

In certain embodiments, a kit for use in orthopedic procedures isprovided that includes a plurality of augments, each comprising asurface having a recessed pocket configured to receive a fixationmaterial, a rim around at least a portion of the recessed pocket, and aport in the rim, wherein at least one of the plurality of augments hasmore than one port in the rim.

In certain embodiments, an orthopedic augment is provided that includesan outer surface that interfaces with a patient's tissue or bone, and aninner surface that interfaces with an implant, the inner surfacecomprising recessed means for receiving a fixation material, a rimaround at least a portion of the recessed means, and access means in therim, wherein the recessed means extend along the inner surface in atleast a direction laterally from the access means.

Variations and modifications of these embodiments will occur to those ofskill in the art after reviewing this disclosure. The foregoing featuresand aspects may be implemented, in any combination and subcombinations(including multiple dependent combinations and subcombinations), withone or more other features described herein. The various featuresdescribed or illustrated above, including any components thereof, may becombined or integrated in other systems. Moreover, certain features maybe omitted or not implemented.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects and advantages will be apparent uponconsideration of the following detailed description, taken inconjunction with the accompanying drawings, in which like referencecharacters refer to like parts throughout, and in which:

FIG. 1A shows a perspective view of an illustrative augment having arecessed pocket;

FIG. 1B shows a front elevation view of the illustrative augment of FIG.1A;

FIG. 1C shows a side elevation view of the illustrative augment of FIG.1A adjacent to an implant;

FIG. 1D shows a top plan view of the illustrative augment of FIG. 1Aadjacent to an implant;

FIG. 2 shows a perspective view of an acetabular shell and anillustrative augment having a plurality of ports;

FIGS. 3A-3F show partial cross-sectional views of illustrative ports,and FIG. 3F also shows an illustrative insertion device coupled thereto;

FIG. 4 shows a perspective view of an illustrative augment having arecessed pocket and a mounting member;

FIGS. 5A and 5B show perspective views of an illustrative augment havingmultiple recessed pockets;

FIG. 5C shows a cross-sectional view of the illustrative augment of FIG.5A, taken along line C-C;

FIG. 5D shows a top plan view of the illustrative augment of FIGS. 5Aand 5B adjacent to an implant; and

FIGS. 6A and 6B show perspective views of an illustrative augment havingvarious surface finishes.

DETAILED DESCRIPTION

To provide an overall understanding of the systems, devices, and methodsdescribed herein, certain illustrative embodiments will be described.Although the embodiments and features described herein are specificallydescribed for use in connection with acetabular systems, it will beunderstood that all the components, connection mechanisms, adjustablesystems, manufacturing methods, coatings, and other features outlinedbelow may be combined with one another in any suitable manner and may beadapted and applied to medical devices and implants to be used in othersurgical procedures, including, but not limited to orthopedic kneereplacement procedures, spine arthroplasty, cranio-maxillofacialsurgical procedures, hip arthroplasty, shoulder arthroplasty, as well asfoot, ankle, hand, and other extremity procedures.

The augments described herein provide a surgeon with unitization optionsto accommodate a wide variety of bone anatomies and implant structures.The augments preferably maintain a close interface with both an implantand a patient's surrounding bone or tissue while allowing the surgeon toplace the augments in a variety of positions, either before or afterimplantation of the implant, in order to suit different bone anatomiesand implant structures. In addition, the augments incorporate recessedpockets into which a fixation material, such as cement, may bedeposited. The recessed pockets allow pressurized deposition of thefixation material into locations that provide improved bonding across agreater surface area between the augment and the implant to which theaugment is coupled.

FIG. 1A shows a perspective view of an augment 100 having a recessedpocket 130 within an inner surface 120 of the augment 100. The augment100 has an outer surface 110 that interfaces with a patient's tissue orbone and an inner surface 120 that interfaces with an implant. The innersurface 120 has a recessed pocket 130 formed therein that, as shown inFIG. 1A, occupies a substantial area of the inner surface 120 and isconfigured to receive a fixation material such as a cement or paste.When injected into the recessed pocket 130, the cement or paste affixesthe augment 100 to an implant. Any suitable cement or paste may be used,including but not limited to polymethyl-methacrylate (PMMA), any othersuitable biocompatible cement or paste, or other fixation material, orany combination thereof. In certain embodiments, the fixation material(e.g., PMMA) may be mixed with one or more pharmacological agentsincluding, but not limited to, antibiotics, anti-inflammatory drugs, andgrowth factors.

The inner surface 120 also includes a rim 140 that mates with an implantand extends around at least a portion of the recessed pocket 130. Asshown in FIG. 1A, for example, the rim 140 encircles the perimeter ofthe recessed pocket 130 along the periphery of the inner surface 120.When the augment 100 is positioned against an implant, the rim 140substantially prevents a fixation material disposed in the recessedpocket 130 from leaving the recessed pocket 130. For example, the rim140 is configured to mate with an implant and may be shaped so that therim 140 matches the geometry of the implant and abuts the implant, whichprevents a fixation material from leaving the recessed pocket 130. Asshown in FIGS. 1C and 1D, the rim 140 has a curvilinear or arced shapeto complement the shape of an implant 190 such as an acetabular shell.In certain embodiments, the rim 140 may be optionally coated with aresorbable or non-resorbable material such as a polylactic plastic (PLA)or PGA plastic. In certain embodiments, a gasket or other sealing meansmay be optionally provided between the rim of the augment and theimplant. The gasket may help to contain the fixation material with therecessed pocket.

In order to allow a surgeon to inject or otherwise insert a fixationmaterial into the recessed pocket 130, the inner surface 120 includes aport 150 within the rim 140 that extends from the outer surface 110 tothe recessed pocket 130 of the inner surface 120. As shown in FIG. 1A,for example, the port 150 is disposed in the top of the rim 140 andextends from the superior outer surface 110 a to the recessed pocket130, thereby allowing a surgeon to inject a fixation material into therecessed pocket 130 when the augment 100 is mated with an implant. Thiscan be done before or after the implant and augment have been implantedinto a patient. The port 150 is shown as a half-circle or half-ovalcutout made into the top of the rim 140 and having an open end 150 a. Incertain embodiments, a port may be provided as a through-hole made intothe rim 140. For example, port 152 is provided as a through-hole in therim 140. Alternatively, or additionally, in certain embodiments a port154 may be provided as a through-hole in the outer surface 110 thataccesses the recessed pocked 130 but is not disposed in the rim 140.

The port 150 assists with the injection of a fixation material intodesired areas of the augment regardless of where the augment ispositioned relative to the implant or whether the augment is affixed tothe implant before or after the two components are implanted. Unlikecurrent augment designs, where if the surgeon desires to use cement, thesurgeon must first cement the augment to the implant beforeimplantation, the recessed pockets described herein (such as recessedpocket 130) allow surgeons to place the augment adjacent to the implantin the desired location before or after implantation and then fill therecessed pocket with the fixation material via the port, therebyaffixing the augment to the implant. Thus, the features of the augment100 provide improved securement options for surgeons to implant augmentsbefore or after the acetabular shell or other implant has beenimplanted.

FIG. 1B shows a front elevation view of the inner surface 120 of theaugment 100 of FIG. 1A, including the recessed pocket 130, the rim 140that substantially encircles the recessed pocket 130, and the port 150disposed on an upper portion of the rim 140. As shown in FIG. 1B, therecessed pocket 130 has a shape that conforms to the shape of theaugment 100 itself, although in certain embodiments the recessed pocket130 may have any suitable shape including shapes that may not comportwith the shape of the augment 100, yet still fit within the innersurface 120 of the augment 100. The rim 140 extends around at least aportion of the recessed pocket 130 and, as shown in. FIG. 1B, extendsaround the entirety of the recessed pocket 130. The rim 140 provides thesurface with which the augment 100 mates with an implant and alsoprevents a fixation material within the recessed pocket 130 from leavingthe pocket 130 when the augment is adjacent the implant. For example, incertain embodiments the rim 140 makes a fluid-tight seal with thesurface of the implant. In certain embodiments, contact that does notcreate a fluid-tight seal may still be sufficient to prevent thefixation material from leaving the recessed pocket 130. Disposed withinthe upper portion of the rim 140 is the port 150 that provides access tothe recessed pocket 130.

As discussed above, the lira 140 provides that portion of the innersurface 120 that contacts an orthopedic implant. FIG. 1C shows a sideelevation view of the augment 100 of FIG. 1A adjacent to an implant 190.The rim 140 of the augment 100 mates with the implant 190 and is shapedto complement the shape of the implant 190. The rim 140 makes asubstantially flush contact with the implant 190, which substantiallyprevents a fixation material within the recessed pocket 130 from leavingthe recessed pocket 130. As discussed above, the recessed pocket 130 canhave any suitable shape. The recessed pocket 130 can also be providedwith any suitable depth, where the depth 130 a depicted in FIG. 1C isthe absolute depth of the pocket, as the depth varies with proximity tothe rim 140. The depth 130 a of the recessed pocket 130 is proportionalto the amount of fixation material that may be deposited within therecessed pocket 130 to affix the augment 100 to the implant 190. Incertain embodiments, it may be desirable to provide a recessed pocket130 having a relatively large depth 130 a. For example, the depth of therecessed pocket (e.g., depth 130 a) may be designed as deep as possiblewithout sacrificing the material strength of the augment or fixationmaterial. Suitable depths include, for example, about 1-10 millimeters,about 2-5 millimeters, or about 2-3 millimeters.

Because the rim 140 mates substantially flush with the implant 190, oneor more ports 150 are provided to give a surgeon access to the recessedpocket 130 in order to inject or otherwise insert the fixation materialinto the recessed pocket 130. FIG. 1D shows a top plan view of theaugment 100 of FIG. 1C and depicts the port 150 disposed in the upperportion of the rim 140 and extending from the recessed pocket 130 to thesuperior outer surface 110 a. Although only one port 150 is shown, itwill be understood that any suitable number of ports may be providedand, moreover, that the ports may be provided on any suitable portion ofthe outer surface 110 of the augment 100. For example, although the port150 is shown on the superior outer surface 110 a, alternatively oradditionally, ports may be provided on the lateral outer surfaces 110 band the inferior outer surface 110 c.

As shown in FIGS. 1A-1D, the recessed pocket 130 extends beyond theopening created by the port 150. In particular, the recessed pocket 130extends along the inner surface 120 in at least a direction laterallyfrom the port 150, as depicted by the direction of arrows 144 of FIG.1D. The recessed pocket 130 therefore has a volume that does not dependupon the size of the port 150. As shown in FIGS. 1C and 1D, the recessedpocket 130 also has a depth 130 a that extends beyond the openingcreated by the port 150.

As discussed above, in certain configurations the augment may includemore than one port. FIG. 2 shows a perspective view of an implantadjacent to an augment having multiple ports. In particular, FIG. 2shows an implant 202, in this case an acetabular shell, and an augment200 mated thereto and having three ports 212, 214, 216. The ports 212,214, 216 are located on the superior outer surface 210 a and extendthrough the top rim 240 of the augment 200. The augment 200 includes arecessed pocket 230, accessible from any of the ports 212, 214, 216.Providing multiple ports gives the surgeon the option, for example, touse any or all of them to inject a fixation material into the recessedpocket 230. For example, in certain embodiments, the operating windowwithin which the surgeon works may be restricted so that one or moreports are not be accessible. However, because three ports 212, 214, 216are provided, at least one of the ports may be accessible and thesurgeon may fill the recessed pocket 230 by injecting a fixationmaterial into that port. It will be understood that any suitable numberof ports may be provided. For an augment having two or more ports, asurgeon would have similar options to use alternate ports if one or moreports are inaccessible for certain orientations of the augment withrespect to an implant.

The above description applies to acetabular augments. However, similarrecessed pockets could be applied to knee augments or other orthopedicimplants where component are fixed together with a fixation materialsuch as bone cement. An additional advantage of providing multiple portsis that a surgeon can inject the fixation material into one of the portsand use an unused port as a fill gauge to visually judge the amount offixation material that has been injected into the augment. For example,as the recessed pocket is filled with fixation material, the surgeon canobserve the fixation material through the unused port by looking intothat port. This is helpful because the recessed pocket extends beyondthe opening of the port. Numerous ports also give a surgeon the optionto place the augment in any desired orientation, where at least one portis accessible from any orientation.

Although the ports 212, 214, 216 are shown as each having substantiallythe same geometry, it will be understood that any suitable geometry maybe provided. For example, certain port geometries may be preferred fordifferent types of syringes or other insertion devices used by thesurgeon to inject a fixation material into the recessed pocket of anaugment. As shown in FIG. 3A, a port 250 can have a straight-edge cut252 through, for example, the outer surface of an augment. FIG. 3B showsthat a port 255 can be tapered 257, while FIG. 3C shows a port 260having both a tapered portion 262 and a straight-edge portion 264 tocreate a funnel-shaped port 260. In certain embodiments, any of ports250, 255, 260 may be configured to include an integral lip at the uppersurface for interfacing with an insertion device. In certainembodiments, the ports may include an insertion device fitting in orderto assist with injection of the fixation material into the recessedpocket. A luer-lock type fitting, shown in FIGS. 3D (female luer-lock270) and 3E (male luer-lock 275), or tapered plug 282, shown in FIG. 3F,may be incorporated into the port and outer surface so that a standardinsertion device may be used, rather than requiring the surgeon tomodify the insertion device. The insertion device fitting (e.g., theluer-lock or plug) allows for greater pressure to be generated,assisting with adequate flow of the fixation material into the gapbetween the augment and the implant and enhancing the fixation betweenthe two components. In certain embodiments, both a plug and a luer-lockfitting are used. For example, as shown in FIG. 3F, in lieu of attachingthe insertion device 290 directly to the plug 282 disposed within theport 280, an extension tube 294 coupled to the insertion device 290 viaa luer-lock 292 is used. The extension tube 294 prevents interference,for example, from soft tissues proximate the port 280. In certainembodiments, the extension member such as extension tube 294 can havealternative fittings (e.g., other than the luer-lock 292) for varioussyringe types or other insertion devices.

In addition to configurations of augments having multiple ports, incertain configurations, augments may include mounting members such asflanges, blades, hooks, plates, or any combination thereof, to assistwith mounting the augment to the implant, the patient's tissue or bone,or both. Mounting members provide additional support and/or stabilityfor the augment once positioned. Mounting members are often preferreddue to bone degeneration, bone loss, or bone defects in the affectedarea (e.g., a hip joint). FIG. 4 shows a perspective view of an augment300 having a mounting member 360. The mounting member 360 is a flangewith one or a plurality of screw holes 362 configured to receive afixation member such as a bone screw. In some embodiments, mountingmembers such as mounting member 360 may include conventional screwholes, locking holes, combi-holes, or slots. The sites may be threaded,unthreaded, or partially threaded, and may be fixed or polyaxial. Insome embodiments, attachment sites may include variable low-profileholes that allow for locking at a variety of angles. The flange mountingmember 360 is coupled to, and extends from, the outer surface 310 of theaugment 300.

The inner surface 320 of the augment 300 has similar features asdiscussed above in connection with augment 100 of FIG. 1A, such as arecessed pocket 330 surrounded at least in part by a rim 340 and a port350 therethrough that provides access to the recessed pocket 330. Theport 350 is provided in the bottom 340 a of the rim 340 and extends tothe inferior outer surface 310 c of the augment 300. It will beunderstood, however, that the port 350 (or additional ports, notdepicted) could be provided on one or both lateral sides of the rim oron the top of the rim, similar to the location of the port 150 of FIG.1A (e.g. along the top 340 b of the rim, adjacent the mounting member360 and the screw holes 362). Furthermore, in certain embodiments, oneor more ports could be provided on a part of the outer surface 310 thatprovides access to the recessed pocket 330 without going through the rim340 (e.g. through a back side of the pocket). As shown, the rim (e.g.,rim 140 and 340) substantially encircles the perimeter of the recessedpocket and thereby provides a perimeter for the recessed pocket and aperimeter for the inner surface. In certain embodiments, however, therim may not fully encircle the perimeter of the recessed pocket. Forexample, an augment may include multiple recessed pockets.

FIGS. 5A and 5B show perspective views of an augment having multiplerecessed pockets. Multiple pockets give a surgeon various options duringthe procedure. For example, not every pocket need be filled with afixation element. Furthermore, the pockets can be designed withdifferent respective volumes depending, for example, on patient-specificor implant-specific applications. As shown in FIG. 5A, for example, theaugment 400 includes an inner surface 420 having recessed pockets 430,432, 434. The rim 440 of augment 400 is provided around at least aportion of each of the recessed pockets 430, 432, 434, although the rim440 does not fully encircle the perimeter of any one recessed pocket430, 432, 434. For example, the rim 440 provides an upper bound and alower bound for the central recessed pocket 430, and provides a lateralbound for the lateral recessed pocket 432 and a lateral bound for thelateral recessed pocket 434. Disposed between the respective recessedpockets are ridges 442 a and 442 b. The ridges 442 a and 442 b do notextend as far as the rim 440, and therefore do not contact an implantwhen the augment 400 is placed adjacent to an implant (although incertain embodiments at least a portion of the ridges 442 a and 442 bcould be configured to contact an implant). It will be understood thatthe ridges 442 a and 442 b may have any suitable respective height. Theaugment 400 includes two ports 450 and 452, where port 450 providesdirect access to lateral recessed pocket 432 and port 452 providesdirect access to lateral recessed pocket 434. Although there is no portshown that provides direct access to the central recessed pocket 430,overfilling either or both of the lateral recessed pockets 432, 434 viaports 450, 452 causes a fixation material to flow over the ridges 442 aand 442 b and thereby fill the central recessed pocket 430. Therefore,access can be provided to a plurality of recessed pockets that areseparated by ridges, even in the event where only one recessed pockethas direct access to a port. In certain embodiments, the multiplerecessed pockets could be provided without ridges between the pockets.For example, the augment could be provided with continuous and/or smoothportions between the pockets or have other ridges or protrusions alongthe inner surface 420 that grasp or otherwise provide a non-smoothstructure with which the fixation material couples.

FIG. 5B is a perspective view of the superior outer surface 410 a andprovides another view of the ports 450, 452. As can be seen in FIG. 5B,for example, the port 452 is shaped similarly to the recessed pocket 434and provides, by use of the ridges 442 a and 442 b, indirect access tothe central recessed pocket 430 and the lateral recessed pocket 432,whereby overfilling the lateral recessed pocket 434 would cause thefixation material to flow to the other recessed pockets 430, 432. As canalso be seen in FIG. 5B, the rim 440 provides the contact surfaceagainst which an implant, is placed, whereas the ridges 442 a and 442 bare inset relative to the rim 440. The ridges 442 a and 442 b do notextend as far the rim 440 and do not contact the implant in order toallow the fixation material to overfill from pocket to pocket. Forexample, as shown in FIG. 5C, which is a cross-sectional view takenalong line C-C of FIG. 5A, the central recessed pocket 430 of theaugment 400 has the greatest depth relative to the rim 440, and theridge 442 b, located between the central recessed pocket 430 and thelateral recessed pocket 434, is inset relative to the rim 440 by adistance, d. The distance, d, between the rim 440 and the ridge 442 b isthe area through which the fixation material is overfilled and flowsfrom pocket to pocket. The ridge 442 b can be provided at any suitabledistance, d, that is inset relative to the rim 440. FIG. 5D shows a topplan view of the augment 400 of FIGS. 5A and 5B. As shown, the ports 450and 452 are provided on the superior outer surface 410 a and each of therecessed pockets 430, 432. 432 has a respective depth from the edge ofthe rim 440, depicted by depths 430 a, 432 a, and 434 a. Also shown arethe ridges 442 a and 442 b that separate the respective pockets. FIG. 5Dalso shows that the rim 440 of the inner surface 410 abuts the implant490, but the ridges 442 a and 442 b are inset and do not contact theimplant 490.

As shown in FIGS. 5A-5D, the lateral recessed pockets 432, 434 extendbeyond the opening created by the ports 450, 452. In particular, thelateral recessed pockets 432, 434 extend along the inner surface 420 inat least a direction laterally from the ports 450, 452, as depicted bythe direction of arrows 444 of FIG. 5D. The central recessed pocket 430does not have a port that provides direct access thereto. The recessedpockets 430, 432, 434 therefore have respective volumes that do notdepend upon the size of the ports 450, 452. As shown in FIGS. 5C and 5D,the recessed pockets also have depths 430 a, 432 a, 434 a that extendbeyond the opening created by the ports 450, 452.

FIGS. 6A and 6B show perspective views of an augment 500 having varioussurface finishes. The augment 500 shown includes two recessed pockets530 and 532 at least partially enclosed by a rim 540 and a mountingflange 560 extending from the augment 500. In certain embodiments, atleast one of the recessed pockets is configured to accept a screw. Forexample, recessed pocket 532 may be configured to accept a screw. Therecessed pockets 530 and 532 are separated at least in part by a ridge542 and are accessible through ports 550 and 552, respectively. Theridge 542 has a height that does not extend as far as that of the rim540, and therefore the ridge 542 does not contact an implant when theaugment 500 is placed adjacent to the implant, such as implant 490.However, in certain embodiments, the ridge 542 can be extended tocontact the implant 490. For example, the ridge 542 may have a heightequal to or greater than that of rim 540. The ports 550 and 552 areshown as half circle or half oval cutouts made into the bottom 540 b ofthe rim 540. It is understood, however, that one or more ports could beprovided on any of the lateral sides 540 a of the rim 540 or on thebottom 540 b or top 540 c of the rim 540, for example, as a through-holeor cut out made into the rim 540, or in any other suitable shape.Furthermore, in certain embodiments, one or more ports could be includedon the outer surface 510 that provide access to the recessed pockets 530and 532 without passing through the rim 540. The inner surface 530 a ofthe recessed pocket 530 and surface 540 d of the rim 540 are shown inFIG. 6A as having a porous composition, while the inner surface 532 a ofthe recessed pocket 532 is shown as having a matte surface finish. Theporous composition allows for better adhesion to fixation material suchas cement or paste. The porous composition may interface with bone topromote ingrowth of the bone. In certain embodiments, the inner surfaces530 a and 532 a in addition to the surface 540 d of the rim 540 mayinclude, at least in part, a variety of different surface treatments,compositions, or coatings. For example, the augment 500 shows a porouscomposition, a matte finish, and a polished finish on the back of theaugment that extends to the mounting flange 560.

The mounting flange 560 extends outward from the augment 500 andincludes six screw holes 562 configured to receive a fixation membersuch as a bone screw. In certain embodiments, any number of screw holes562 may be included. As shown in FIGS. 6A and 6B, the mounting flange560 has an upper surface 564 having a porous composition and a lowersurface 510 having a polished finish. The porous upper surface 564 mayreceive a fixation material, and the polished lower surface 510 may beconfigured to interface with a patient's tissue, muscles, ligaments, orbone, or any combination thereof. The porous upper surface 564 ispreferably configured to interface with bone and promote ingrowth of thebone. The polished lower surface 510 is preferably configured tointerface with a patient's tissue, muscles, and/or ligaments to preventinteractions and attachments between the tissue, muscles, and/orligaments and the polished lower surface 510. In certain embodiments,the upper surface 564 and lower surface 510 may include, at least inpart, a variety of different surface treatments, compositions, orcoatings. For example, the augment 500 shows a mounting flange 560 witha porous composition and a polished finish. Any other suitablecombination of surface treatments may be used on various surfaces of theaugment 500.

The augments described herein may be made of a number of materials,including Titanium, Cobalt-Chromium, Zirconium oxide, Stainless steel,monolithic ceramic or composite ceramic, such as Zirconia, Alumina, orother composites, or any other biocompatible materials or alloys thathave the appropriate strength, resistance to wear, etc., or anycombinations thereof. The augments may also be made fully porous orpartially porous to allow for greater bone in-growth, for example, andthe augments may be coated with hydroxyapatite or any otherbone-promoting agents or combinations thereof. The augments may bemanufactured according to any suitable technique or techniques,including, for example, using rapid manufacturing machines or standardmanufacturing machines.

The foregoing is merely illustrative of the principles of thedisclosure, and the systems, devices, and methods can be practiced byother than the described embodiments, which are presented for purposesof illustration and not of limitation. It is to be understood that thesystems, devices, and methods disclosed herein, while shown for use inacetabular systems, may be applied to systems, devices, and methods tobe used in other surgical procedures including, but not limited to,spine arthroplasty, cranio-maxillofacial surgical procedures, kneearthroplasty, shoulder arthroplasty, as well as foot, ankle, hand, andextremities procedures.

Variations and modifications will occur to those of skill in the artafter reviewing this disclosure. The disclosed features may beimplemented, in any combination and subcombination (including multipledependent combinations and subcombinations), with one or more otherfeatures described herein. The various features described or illustratedabove, including any components thereof, may be combined or integratedin other systems. Moreover, certain features may be omitted or notimplemented.

Examples of changes, substitutions, and alterations are ascertainable byone skilled in the art and could be made without departing from thescope of the information disclosed herein. All references cited hereinare incorporated by reference in their entirety and made part of thisapplication.

1.-35. (canceled)
 36. A method of utilizing an orthopedic augmentstructured for use with an orthopedic implant, wherein the augmentincludes a porous outer surface, an inner surface defining a recessedpocket, a port extending through the outer surface and the inner surfaceto the pocket, and a rim structured to flushly engage the implant, themethod comprising: positioning the augment against the implant with therim flushly engaged with the implant; and affixing the augment to theimplant with the rim flushly engaged with the implant wherein theaffixing includes inserting a fluid fixation material into the pocketvia the port.
 37. The method of claim 36, wherein the positioning andthe affixing are performed with the implant implanted in a patient. 38.The method of claim 36, wherein the positioning includes forming afluid-tight seal between the rim and the implant.
 39. The method ofclaim 36, wherein the inserting of the fixation material into the pocketvia the port includes injecting the fluid fixation material into thepocket via the port and filling the pocket with the fluid fixationmaterial.
 40. The method of claim 36, wherein a fitting is attached tothe port, and wherein the method further comprises attaching aninsertion device to the fitting prior to the affixing, and wherein theaffixing includes operating the insertion device to inject the fluidfixation material into the pocket via the fitting.
 41. The method ofclaim 36, wherein the positioning of the augment against the implantincludes positioning a gasket between the rim and the implant such thatthe rim flushly engages the implant via the gasket.